Search results for: correctional nursing

Authors: K. Shiba, T. Kobayashi, T. Kaburagi, Y. Kurihara

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Elderly population in the world is increasing, and consequently, their nursing burden is also increasing. In such situations, monitoring and evaluating their daily action facilitates efficient nursing care. Especially, we focus on an unconscious activity during sleep, i.e. turnover. Monitoring turnover during sleep is essential to evaluate various conditions related to sleep. Bedsores are considered as one of the monitoring conditions. Changing patient’s posture every two hours is required for caregivers to prevent bedsore. Herein, we attempt to develop an unconstrained nocturnal monitoring system using a sensing device based on piezoelectric ceramics that can detect the vibrations owing to human body movement on the bed. In the proposed method, in order to construct a multi-points sensing, we placed two sensing devices under the right and left legs at the head-side of an ordinary bed. Using this equipment, when a subject lies on the bed, feature is calculated from the output voltages of the sensing devices. In order to evaluate our proposed method, we conducted an experiment with six healthy male subjects. Consequently, the period during which turnover occurs can be correctly classified as the turnover period with 100% accuracy.

Keywords: Turnover, piezoelectric ceramics, multi-points sensing, unconstrained monitoring system.

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: Imprisonment, imprisoned women, prison healthcare, prison policies.

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: Health care, nurse education, nurse leadership, nursing in Iraq, transformational leadership.

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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Authors: Li-Ping Hsiao, Feng-Chuan Pan

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Leave of absence is important in maintaining a good status of human resource quality. Allowing the employees temporarily free from the routine assignments can vitalize the workers- morality and productivity. This is particularly critical to secure a satisfactory service quality for healthcare professionals of which were typically featured with labor intensive and complicated works to perform. As one of the veteran hospitals that were found and operated by the Veteran Department of Taiwan, the nursing staff of the case hospital was squeezed to an extreme minimum level under the pressure of a tight budgeting. Leave of absence on schedule became extremely difficult, especially for the intensive care units (ICU), in which required close monitoring over the cared patients, and that had more easily driven the ICU nurses nervous. Even worse, the deferred leaves were more than 10 days at any time in the ICU because of a fluctuating occupancy. As a result, these had brought a bad setback to this particular nursing team, and consequently defeated the job performance and service quality. To solve this problem and accordingly to strengthen their morality, a project team was organized across different departments specific for this. Sufficient information regarding jobs and positions requirements, labor resources, and actual working hours in detail were collected and analyzed in the team meetings. Several alternatives were finalized. These included job rotating, job combination, leave on impromptu and cross-departmental redeployment. Consequently, the deferred leave days sharply reduced 70% to a level of 3 or less days. This improvement had not only provided good shelter for the ICU nurses that improved their job performance and patient safety but also encouraged the nurses active participating of a project and learned the skills of solving problems with colleagues.

Keywords: Information, job rotating, human resource, intensive care unit.

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Authors: Jenan Shakoor

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Obesity prevalence is increasing worldwide. University life is a challenging period especially for students who have to leave their familiar surroundings and settle in a new environment. The current study aimed to assess the diet and exercise habits and their association with body mass index (BMI) among nursing college students living at Kirkuk University residence. This was a descriptive study. A non-probability (purposive) sample of 101 students living in Kirkuk University residence was recruited during the period from the 15^th November 2015 to the 5^th May 2016. A questionnaire was constructed for the purpose of the study which consisted of four parts: the demographic characteristics of the study sample, eating habits, eating at college and healthy habits. The data were collected by interviewing the study sample and the weight and height were measured by a trained researcher at the college. Descriptive statistical analysis was undertaken. Data were prepared, organized and entered into the computer file; the Statistical Package for Social Science (SPSS 20) was used for data analysis. A p value≤ 0.05 was accepted as statistical significant. A total of 63 (62.4%) of the sample were aged20-21with a mean age of 22.1 (SD±0.653). A third of the sample 38 (37.6%) were from level four at college, 67 (66.3%) were female and 46 45.5% of participants were from a middle socio-economic status. 14 (13.9%) of the study sample were overweight (BMI =25-29.9kg/m²) and 6 (5.9%) were obese (BMI≥30kg/m²) compared to 73 (72.3%) were of normal weight (BMI =18.5-24.9kg/m²). With regard to eating habits and exercise, 42 (41.6%) of the students rarely ate breakfast, 79 (78.2%) eat lunch at university residence, 77 (78.2%) of the students reported rarely doing exercise and 62 (61.4%) of them were sleeping for less than eight hours. No significant association was found between the variables age, sex, level of college and socio-economic status and BMI, while there was a significant association between eating lunch at university and BMI (p =0.03). No significant association was found between eating habits, healthy habits and BMI. The prevalence of overweight and obesity among the study sample was 19.8% with female students being more obese than males. Further studies are needed to identify BMI among residence students in other colleges and increasing the awareness of undergraduate students to healthy food habits.

Keywords: Body mass index, diet, obesity, university residence.

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Authors: Mohamed Elhadi M. Sharif, Mona Masood

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The usage of e-health facilities is seen to be the first priority by the Libyan government. As such this paper focuses on how the key factors or elements of working size in terms of technological availability, structural environment, and other competence-related matters may affect nurses’ sharing of knowledge in e-health. Hence, this paper investigates learning readiness assessment to raise e-health for Libyan regional hospitals by using ehealth services in nursing education.

Keywords: Libyan nurses, e-Learning readiness, e-Health.

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Authors: Naoto Suzuki

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Medical methods to completely treat glaucoma are yet to be developed. Therefore, ophthalmologists manage patients mainly to delay disease progression. Patients with glaucoma are mainly elderly individuals. In elderly people's houses, having an equipment that can provide medical treatment and care can release their family from their care. For elderly people with the glaucoma to live by themselves as much as possible, we developed a support robot having five functions: elderly people care, ophthalmological examination, trip assistance to the neighborhood, medical treatment, and data referral to a hospital. The medical and nursing care robot should approach the visual field that the patients can see at a speed suitable for their eyesight. This is because the robot will be dangerous if it approaches the patients from the visual field that they cannot see. We experimentally developed a robot that brings a white cane to elderly people with glaucoma. The base part of the robot is a carriage, which is a Megarover 1.1, and it has two infrared sensors. The robot moves along a white line on the floor using the infrared sensors and has a special arm, which does not use electricity. The arm can scoop the block attached to the white cane. Next, we also developed a direction detector comprised of a charge-coupled device camera (SVR41ResucueHD; Sun Mechatronics), goggles (MG-277MLF; Midori Anzen Co. Ltd.), and biconvex lenses with a focal length of 25 mm (Edmund Co.). Some young people were photographed using the direction detector, which was put on their faces. Image processing was performed using Scilab 6.1.0 and Image Processing and Computer Vision Toolbox 4.1.2. To measure the people's line of vision, we calculated the iris's center of gravity using five processes: reduction, trimming, binarization or gray scale, edge extraction, and Hough transform. We compared the binarization and gray scale processes in image processing. The binarization process was better than the gray scale process. For edge extraction, we compared five methods: Sobel, Prewitt, Laplacian of Gaussian, fast Fourier transform, and Canny. The Canny method was the optimal extraction method. We performed the Hough transform to search for the main coordinates from the iris's edge, and we found that the Hough transform could calculate the center point of the iris.

Keywords: Glaucoma, support robot, elderly people, Hough transform, direction detector, line of vision.

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: Lean, Service improvement, SERVQUAL, Care home service.

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Authors: J. Fernandez, R. Fernandez de Canete, J. Perea-Paizal, J. C. Ramos-Diaz

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The high prevalence of cardiovascular diseases has provoked a raising interest in the development of mathematical models in order to evaluate the cardiovascular function both under physiological and pathological conditions. In this paper, a physical model of the cardiovascular system with intrinsic regulation is presented and implemented by using the object-oriented Modelica simulation software tools.  For this task, a multi-compartmental system previously validated with physiological data has been built, based on the interconnection of cardiovascular elements such as resistances, capacitances and pumping among others, by following an electrohydraulic analogy. The results obtained under both physiological and pathological scenarios provide an easy interpretative key to analyze the hemodynamic behavior of the patient. The described approach represents a valuable tool in the teaching of physiology for graduate medical and nursing students among others.

Keywords: Cardiovascular system, Modelica simulation software, physical modeling, teaching tool.

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Authors: Nareelux Suwannobol, Plernpit Promrak, Kiattisak Batsungnoen

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The aim of this study was to investigate the environmental conservation behavior of the Applied Health Science students of Suranaree University of Technology, a green and clean university. The sample group was 184 Applied Health Science students (medical, nursing, and public health). A questionnaire was used to collect information. The result of the study found that the students had more negative than positive behaviors towards energy, water, and forest conservation. This result can be used as basic information for designing long-term behavior modification activities or research projects on environmental conservation. Thus Applied Health Science students will be encouraged to be conscious and also be a good example of environmental conservation behavior.

Keywords: Energy conservation behavior, Water conservationbehavior, Forest conservation behavior, Green and clean University.

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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Authors: W. Maddison

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This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to pre-clinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: Global-Local, pre-clinical medical students, student success, transnational higher education, Middle East.

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Authors: Saowaluk Sikiwat, Mayuree Pumipaiboon, Sutee Kaewsangiem, Mayuva Areekijseree

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The problem on the conservation programme of the Royal Thai Navy Sea Turtle Nursery, Phang-nga Province, Thailand is high mortality rate of juvenile green sea turtle (Cheloniamydas) on nursing period. So, during May to October 2012, postmortem examinations of juvenile green sea turtle were performed to determine the causes of dead. Fresh tissues of postmortem of 15 juvenile green sea turtles (1-3 months old) were investigated using paraffin section technique. The results showed normal ultrastructure of all tissue organs. These instances reviewed the health and stability of the environments in which juvenile green sea turtles live and concern for the survival rate. The present article also provides guidance for a review of the biology, guidelines for appropriate postmortem tissue, normal histology and sampling collection and procedures. The data also provides information for conservation of this endangered species in term of acknowledging and encouraging people to protect the animals and their habitats in nature.

Keywords: Green sea turtles (Cheloniamydas), histology, juvenile sea turtles

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Authors: Ç. Erdoğan, T. Turan

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Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

Keywords: Cancer treatment, children, nursing, yoga.

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Authors: Sheila R. Bonito

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This study describes the relationship between motivation factors and academic performance among distance education students enrolled in a postgraduate nursing course. Students (n=96) participated in a survey that assesses student's motivational orientations from a cognitive perspective using a selfadministered questionnaire based on Pintrich-s Motivation Strategies for Learning Questionnaire (MLSQ). Results showed students- motivational factors are highest on task value (6.44, 0.71); followed by intrinsic goal orientation (6.20, 0.76), control beliefs (6.02, 0.89); extrinsic goal orientation (5.85, 1.13); self-efficacy for learning and performance (5.62, 0.84), and finally, test anxiety (4.21, 1.37). Weak positive correlations were found between academic performance and intrinsic goal orientation (r=0.13), extrinsic goal orientation (r=0.04), task value (r=0.09), control beliefs (r=0.02), and self-efficacy (r=0.05), while there was weak negative correlation with test anxiety (r=-0.04). Conclusions from the study indicate the need to focus on improving tasks and targeting intrinsic goal orientations of students to courses since these were positively correlated with academic performance and downplay the use of tests since these were negatively correlated with academic performance.

Keywords: Motivation factors, academic performance, distance education

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Authors: Yuni Suranindyah, Kustantinah, E. R. Ôêàrskov

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The case study was conducted to show the effect of  milking method in goat called half day milking on the milk production and the growth of kids. Data were collected by  interviewing farmers and investigating goat production in the  communal goat housing from June 2008 to May 2009. The interview  was conducted to collect data about goat management. The  observations were conducted on 10 goats, which were selected based  on the uniformity of age, number of kid born/goat and the milking method in practice. The samples were divided into two groups; those  were full 3 months nursing and half day milked goats (in this group the kids were separated from goat during the previous night milking  and then the kids were allowed to suck the goat during the day). The result showed that the communal goat housing had 138 goats and 25% of the farmers milked the goat. The implementation of half day milking increased the milk production significantly (P<0.05) and it did not affect the kids’ growth. It was concluded that half day milking was beneficial to increase milk production. In the communal goat housing was possible to implement the result of this innovation to all members of the farmer group as a method in increasing goat milk production.

Keywords: Communal goat housing, milk production.

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Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: Energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities.

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Authors: Jun-ya Nagase, Toshiyuki Satoh, Norihiko Saga, Koichi Suzumori

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In recent years, Japanese society has been aging, engendering a labor shortage of young workers. Robots are therefore expected to perform tasks such as rehabilitation, nursing elderly people, and day-to-day work support for elderly people. The pneumatic balloon actuator is a rubber artificial muscle developed for use in a robot hand in such environments. This actuator has a long stroke and a high power-to-weight ratio compared with the present pneumatic artificial muscle. Moreover, the dynamic characteristics of this actuator resemble those of human muscle. This study evaluated characteristics of force control of balloon actuator using a predictive functional control (PFC) system with disturbance observer. The predictive functional control is a model-based predictive control (MPC) scheme that predicts the future outputs of the actual plants over the prediction horizon and computes the control effort over the control horizon at every sampling instance. For this study, a 1-link finger system using a pneumatic balloon actuator is developed. Then experiments of PFC control with disturbance observer are performed. These experiments demonstrate the feasibility of its control of a pneumatic balloon actuator for a robot hand.

Keywords: Disturbance observer, Pneumatic balloon, Predictive functional control, Rubber artificial muscle.

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Authors: Tessy Treesa Jose, Sripathy M. Bhat

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Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).

Keywords: Psychiatric morbidity, nurse, selected hospitals, working.

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Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

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We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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Authors: Ladda Leungratanamart, Seree Chadcham

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Fluid intelligence declines along with age, but it can be developed. For this reason, increasing fluid intelligence in young adults can be possible. This study examined the effects of a two-month treadmill exercise program on fluid intelligence. The researcher designed a treadmill exercise program to promote cardiorespiratory fitness. Thirty-eight healthy voluntary students from the Boromarajonani College of Nursing, Chon Buri were assigned randomly to an exercise group (n=18) and a control group (n=20). The experiment consisted of three sessions: The baseline session consisted of measuring the VO₂max, electroencephalogram and behavioral response during performed the Raven Progressive Matrices (RPM) test, a measure of fluid intelligence. For the exercise session, an experimental group exercises using treadmill training at 60 % to 80 % maximum heart rate for 30 mins, three times per week, whereas the control group did not exercise. For the following two sessions, each participant was measured the same as baseline testing. The data were analyzed using the t-test to examine whether there is significant difference between the means of the two groups. The results showed that the mean VO₂ max in the experimental group were significantly more than the control group (p<.05), suggesting a two-month treadmill exercise program can improve fluid intelligence. When comparing the behavioral data, it was found that experimental group performed RPM test more accurately and faster than the control group. Neuroelectric data indicated a significant increase in percentages of alpha band ERD (%ERD) at P3 and Pz compared to the pre-exercise condition and the control group. These data suggest that a two-month treadmill exercise program can contribute to the development of cardiorespiratory fitness which influences an increase fluid intelligence. Exercise involved in cortical activation in difference brain areas.

Keywords: Treadmill exercise, fluid intelligence, raven progressive matrices test, %ERD of upper Alpha band.

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Pei-Ti Hsu, I-Ju Chen, Jeu-Jung Chen, Cheng-Fen Chang, Shiu-Yan Yang

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Background: Taiwan now is an aging society. Research on the elderly should not be confined to caring for seniors, but should also be focused on ways to improve health and the quality of life. Senior citizens who participate in volunteer services could become less lonely, have new growth opportunities, and regain a sense of accomplishment. Thus, the question of how to get the elderly to participate in volunteer service is worth exploring. Objective: Apply the Transtheoretical Model to understand stages of change in regular volunteer service and voluntary service behaviour among the seniors. Methods: 1525 adults over the age of 65 from the Renai district of Keelung City were interviewed. The research tool was a self-constructed questionnaire, and individual interviews were conducted to collect data. Then the data was processed and analyzed using the IBM SPSS Statistics 20 (Windows version) statistical software program. Results: In the past six months, research subjects averaged 9.92 days of volunteer services. A majority of these elderly individuals had no intention to change their regular volunteer services. We discovered that during the maintenance stage, the self-efficacy for volunteer services was higher than during all other stages, but self-perceived barriers were less during the preparation stage and action stage. Self-perceived benefits were found to have an important predictive power for those with regular volunteer service behaviors in the previous stage, and self-efficacy was found to have an important predictive power for those with regular volunteer service behaviors in later stages. Conclusions/Implications for Practice: The research results support the conclusion that community nursing staff should group elders based on their regular volunteer services change stages and design appropriate behavioral change strategies.

Keywords: Seniors, stages of change in regular volunteer services, volunteer service behavior, self-efficacy, self-perceived benefits.

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Authors: Tuba Tekin, Nurcan Baglam, Emine Dincer

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This study aimed to examine the effects of nutrition education received by university students on sustainable healthy eating behaviors and adherence to the Mediterranean diet. The 2nd, 3rd, and 4th-grade university students studying at the Faculty of Health Sciences, Nutrition and Dietetics, Midwifery, Nursing, Physical Therapy, and Rehabilitation departments of universities in Turkey were included in the study. Students' adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale, and their sustainable and healthy eating behaviors were evaluated using the Sustainable and Healthy Eating Behaviors Scale. In addition, the body weight and height of the students were measured by the researchers, and the Body Mass Index (BMI) value was calculated. A total of 181 students, 85 of whom were studying in the Department of Nutrition and Dietetics and 96 of whom were educated in other departments, were included in the study; 75.7% of the students in the sample are female, while 24.3% are male. The average body weight of the students was 61.17 ± 10.87 kg, and the average BMI was 22.04 ± 3.40 kg/m2. While the mean score of the Mediterranean Diet Adherence Scale was 6.72 ± 1.84, in the evaluation of adherence to the Mediterranean diet, it was determined that 25.4% of the students had poor adherence and 66.9% needed improvement. When the adherence scores of students who received and did not receive nutrition education were compared, it was discovered that the students who received nutrition education had a higher score (p < 0.05). Students who received nutrition education had a higher total score on the Sustainable and Healthy Eating Behaviors scale (p < 0.05). A moderately positive correlation was found between the Sustainable and Healthy Eating Behaviors scale total score and the Mediterranean Diet Adherence scores (p < 0.05). As a result of the linear regression analysis, it was revealed that a 1-unit increase in the Mediterranean diet adherence score would result in a 1.3-point increase in the total score of the Sustainable and Healthy Eating Behaviors scale. Sustainable and healthy diets are important for improving and developing health and the prevention of diseases. The Mediterranean diet is defined as a sustainable diet model. The findings revealed the relationship between the Mediterranean diet and sustainable nutrition and showed that nutrition education increased knowledge and awareness about sustainable nutrition and increased adherence to the Mediterranean diet. For this reason, courses or seminars on sustainable nutrition can be organized during educational periods.

Keywords: Healthy eating, Mediterranean diet, nutrition education, sustainable nutrition.

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Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: Education, innovation. nursing, urban.

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Authors: O. F. Elkommos

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“Humour studies” is an interdisciplinary research area that is relatively recent. It interests researchers from the disciplines of psychology, sociology, medicine, nursing, in the work place, gender studies, among others, and certainly teaching, language learning, linguistics, and literature. Linguistic theories of humour research are numerous; some of which are of interest to the present study. In spite of the fact that humour courses are now taught in universities around the world in the Egyptian context it is not included. The purpose of the present study is two-fold: to review the state of arts and to show how linguistic theories of humour can be possibly used as an art and craft of teaching and of learning in EFL literature classes. In the present study linguistic theories of humour were applied to selected literary texts to interpret humour as an intrinsic artistic communicative competence challenge. Humour in the area of linguistics was seen as a fifth component of communicative competence of the second language leaner. In literature it was studied as satire, irony, wit, or comedy. Linguistic theories of humour now describe its linguistic structure, mechanism, function, and linguistic deviance. Semantic Script Theory of Verbal Humor (SSTH), General Theory of Verbal Humor (GTVH), Audience Based Theory of Humor (ABTH), and their extensions and subcategories as well as the pragmatic perspective were employed in the analyses. This research analysed the linguistic semantic structure of humour, its mechanism, and how the audience reader (teacher or learner) becomes an interactive interpreter of the humour. This promotes humour competence together with the linguistic, social, cultural, and discourse communicative competence. Studying humour as part of the literary texts and the perception of its function in the work also brings its positive association in class for educational purposes. Humour is by default a provoking/laughter-generated device. Incongruity recognition, perception and resolving it, is a cognitive mastery. This cognitive process involves a humour experience that lightens up the classroom and the mind. It establishes connections necessary for the learning process. In this context the study examined selected narratives to exemplify the application of the theories. It is, therefore, recommended that the theories would be taught and applied to literary texts for a better understanding of the language. Students will then develop their language competence. Teachers in EFL/ESL classes will teach the theories, assist students apply them and interpret text and in the process will also use humour. This is thus easing students' acquisition of the second language, making the classroom an enjoyable, cheerful, self-assuring, and self-illuminating experience for both themselves and their students. It is further recommended that courses of humour research studies should become an integral part of higher education curricula in Egypt.

Keywords: ABTH, deviance, disjuncture, episodic, GTVH, humour competence, humour comprehension, humour in the classroom, humour in the literary texts, humour research linguistic theories, incongruity- resolution, isotopy-disjunction, jab line, longer text joke, narrative story line (macro-micro), punch line, six knowledge resource, SSTH, stacks, strands, teaching linguistics, teaching literature, TEFL, TESL.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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